An 18-yr-old college freshman basketball player at a Division I university suffered chest pain, dyspnea, and dizziness followed by syncope while running a 400-m dash. After an extensive multidisciplinary workup that eliminated all organic causes, the patient, an only child from a remote rural area, was found to be suffering from panic attacks with mild features of agoraphobia. Exertional chest pain is a common complaint in young athletes. The etiologies are myriad and can be referable to many organ systems; however, the cause is usually benign. Psychogenic origin is uncommon but must be considered when organic causes have been ruled out and the patient's social history is suggestive.